AHIP's new hires: America's Health Insurance Plans, the industry group representing health insurers, announced two new hires in an internal memo late Tuesday. The additions to the "senior leadership team" come "as we restructure to meet the advocacy and policy needs of a new era in health care" AHIP President and CEO said in the memo.

Here's the announcement:

"Joe Miller, General Counsel 

Joe comes to AHIP from the Antitrust Division of the Department of Justice, where he was the Assistant Chief of the litigating section with responsibility for health care and health insurance.  He led the Antitrust Division’s competition advocacy efforts in health care, writing and testifying to state boards and legislatures about the consumer harm associated with Certificate of Need regulation.  Joe also was an antitrust attorney in private practice with the firm of Collier, Shannon, Rill & Scott, and began his career as a staff attorney with the Federal Trade Commission.  He received his undergraduate degree in Economics from Emory University in 1986, and his law degree from George Mason University in 1991.

Daniel Durham, Executive Vice President for Policy and Regulatory Affairs 

Dan has over 25 years of leadership experience with major policy and regulatory issues, primarily in the health care field.  He is currently the Vice President for Policy at PhRMA, where he played a very significant leadership role during health care reform and implementation of the Medicare prescription drug benefit.  He previously served in high-level policy positions in the federal government at the Department of Health and Human Services, the Office of Management and Budget, and the Social Security Administration.  Dan also held key positions at AARP and the California Legislative Analyst’s Office.  He received his undergraduate degree in government and philosophy from the University of Notre Dame and a master’s in public policy from Duke University.  Dan joins our team effective November 15th."

State disparities raise reform doubts: Wide disparities in state-by-state average annual costs for employee health plans might have implications regarding the future implementation of health insurance exchanges and co-operatives, according to the United Benefit Advisors 2010 Health Plan Survey — the nation’s largest and most comprehensive survey of plan design and plan costs: http://bit.ly/aiG1Uc

AEI questions AARP's drug price reports: The lobbying group for older Americans is "scaring seniors" with alarmist quarterly drug price reports that don't take into account generic-drug prices, the conservative American Enterprise Institute argues in a new report. AARP made closing Medicare's "doughnut hole" a top priority during the health reform debate. http://bit.ly/c31vYY

Happening today: AEI holds a conference on "The Competition Prescription for Better Hospital-Care Quality." http://bit.ly/bcErBO

Two more HHS announcements: The Department of Health and Human Services announced two new grants funded by the health reform act on Tuesday. HHS Secretary Kathleen Sebelius announced the availability of up to $335 million for existing community health centers across the country under the Expanded Services (ES) initiative: http://bit.ly/9XLrMx

Separately, Sebelius announced $3.9 million in funding to continue support for Family-to-Family Health Information Centers, non-profit organizations run by families and for families with children with special healthcare needs. http://bit.ly/bUYhcQ

FDA overhaul of device approval process scrutinized: A non-profit representing California's healthcare sector released a new white paper Tuesday on the Food and Drug Administration's proposed changes to its expedited regulatory pathway for new medical technologies. The California Healthcare Institute's report on the more than 60 proposed changes to the 510(k) process argues that "changes to the current process have potential to disrupt the fragile ecosystem that balances academic research, risk capital and the dynamic medical marketplace." http://bit.ly/bTT64X

Grassley questions reassignment of government ethics enforcer: Sen. Chuck Grassley (R-Iowa) is expressing concern that the National Cancer Institute might have punished and transferred its ethics director for trying to make sure agency travel complies with federal law and procedures. In a letter to the institute's director, Harold Varmus, Grassley inquires whether the ethics director was retaliated against after she raised questions about travel sponsored by non-government sources, such as corporations and other private entities.

"Some government agencies have more travel than others. They should be used to transparency and scrutiny to make sure they follow the rules," Grassley said in a statement. "National Cancer Institute executives appear to have taken issue with the scrutiny to sponsored travel given by their then-chief ethics officer. It’s important to get to the bottom of whether the ethics officer was retaliated against just for doing her job."

What are the odds? The chances of the health reform law's individual mandate being "modified, stalled or repealed" if the GOP takes the House are 73 percent, according to an analysis by the firm of former Republican Health and Human Services Secretary Michael Leavitt. Get more details about the mandate and other "targets for disruption" here: http://bit.ly/aXl2bO

Likely modifications include raising the income threshold of those exempt from the requirement or denying funding to the IRS to hire new staff to enforce the provision. If repealed, the individual mandate could be modified to have an auto-enrollment process with an opt-out provision.

The powerful pharmaceutical lobby is pushing back against campaign-trail calls to allow Medicare to negotiate drug prices on behalf of millions of seniors enrolled in Part D.

The Pharmaceutical Research and Manufacturers of America (PhRMA) argues that price negotiations are already being undertaken by insurance companies and pharmacy benefit managers, bringing Part D costs down well below the program's initial projections.

"That’s the marketplace in action and that’s how America’s seniors will see true savings without compromising the search for future cures," Wes Metheny, PhRMA senior vice president, said Tuesday in a statement.

In August, Medicare officials provided evidence for those claims, announcing that average monthly premiums for Part D beneficiaries will be roughly $30 next year — about $1 more than the average rate in 2010.

More recently, though, Avalere Health came up with significantly different numbers. The Washington-based policy group found that the average premium under the drug benefit will jump by 9.5 percent in 2011 — largely due to cost spikes expected in the enhanced-plan market.

Part D is emerging as a prominent campaign issue in some races. In Kentucky, for instance, state Attorney General Jack Conway has made Medicare negotiation a central message in his race to replace outgoing Sen. Jim Bunning (R-Ky.). He argued this week that empowering Medicare to negotiate drug prices — much like the Veterans Health Administration does today — would save taxpayers tens of billions of dollars each year. 

"We need to make certain that Medicare can engage in bulk purchasing," Conway said Monday.

But PhRMA warns that the VA's savings results only because the agency limits the number of drugs available to beneficiaries — a message supported by the Congressional Budget Office.

"While we are committed to making the Medicare prescription drug benefit even better, we remain opposed to restrictive policies that would reduce access of medicines to patients in need and undermine the program’s clear success," Metheny said.

Last fall, House Democrats included Part D negotiation in their healthcare reform bill, but Senate leaders — bound by an agreement with PhRMA — didn't follow suit. It was the Senate bill that ultimately became law. 

Kentucky Senate hopeful Rand Paul (R) warned this week that the patient protections contained in the new healthcare reform law will destroy the insurance market. The Tea Party favorite wants to roll back the law to allow companies to decide for themselves what services they'll cover.

"What I would like to see is a more market-oriented approach," Paul said Monday, responding to the question of whether he supported the law's central insurance reforms, some of which took effect last month. 

Paul said provisions of the "Patient's Bill of Rights" — including the prohibition on denying coverage for pre-existing conditions — "can sound really good on the face of it" but will have harmful consequences over the long haul. 

"Right now I buy insurance — and I'm healthy — but I buy it in case I might get sick. If you tell me I can get it for the same price after I'm sick, why do I buy it?" Paul asked during Monday's debate with his Democratic opponent, Jack Conway. 

"If you give perverse incentives to customers to say, 'Why buy insurance?' then what happens is healthy people drop out, and the system becomes more burdened with sick people. It's really destroying a marketplace."

To discourage healthy Americans from dropping out, the reform law includes a requirement that all Americans purchase health insurance or pay a financial penalty. The individual mandate has been one of the most hotly contested provisions of the law, with more than 20 state attorneys general filing suit challenging the mandate's constitutionality. 

Paul, however, didn't mention that during Monday's debate.

Senators from both parties are urging their leaders to remove a ban on generic drug settlements from an appropriations bill that will be considered during the lame-duck session.

The provision would end the practice of brand-name drug makers settling patent challenges from generic manufacturers by paying them to delay their products.

The Federal Trade Commission (FTC) argues the settlements are a form of collusion that keeps cheaper generics off the market and says banning them would save American consumers at least $3.5 billion a year in cheaper medications.

The Health and Human Services Department (HHS) is accepting applications for $335 million in grants to help community health centers serve low-income patients, the agency announced Tuesday.

The grants — part of $11 billion in new funding for community health centers included in the health reform law — will be available to existing facilities able to demonstrate the money will expand capacity and care for the underserved (and underinsured) patients they tend to treat.

“These new investments will allow existing health centers to improve and expand vital primary health care services, and continue to meet the increased demand for services,” Mary Wakefield, head of the Health Resources and Services Administration, said in a statement. 

Earlier in the month, HHS announced the recipients of $727 million in grants for community health centers — funding also included in the new healthcare law.

Applications for the new grants are due Jan. 6.

The Senate Democratic candidate in Kentucky wants to rein in Medicare spending by allowing the government to negotiate prices directly with drug makers — a proposal rejected by Democrats as part of a healthcare reform deal cut with the pharmaceutical lobby last year.

State Attorney General Jack Conway (D), running to replace retiring GOP Sen. Jim Bunning, said the deal represented a missed opportunity to save taxpayers hundreds of billions of dollars.

"It made no sense to me, in talking about trying to achieve savings in Medicare, that a sweetheart deal was cut with the pharmaceutical companies," Conway said during a Monday night debate with GOP candidate Rand Paul. "The Medicaid system negotiates for lower prices. The VA system negotiates for lower prices. 

"If Medicare were allowed to do that … it would be $200 billion — that's 200 billion with a "B" — in savings. That's some real money."

When Congress created Medicare's prescription drug benefit in 2003, the law explicitly prohibited the government from negotiating with drug makers on behalf of the millions of seniors who would enroll in the program. 

The law also moved low-income seniors — those eligible for both Medicare and Medicaid — into Medicare drug plans. Previously, those "dual eligibles" got their drugs through state Medicaid programs, which are allowed to negotiate prices directly with pharmaceutical companies.

Those provisions brought the drug lobby behind the bill, but didn't come cheap for taxpayers. Indeed, a 2008 study from the House Oversight and Government Reform Committee found that the government currently pays about 30 percent more for dual eligibles’ drugs under Medicare than it would under Medicaid.

A more recent analysis from the National Committee to Preserve Social Security and Medicare found that allowing the government to negotiate Part D prices would save taxpayers $24 billion each year.

That didn't happen. Instead, in the early months of the healthcare reform debate, Senate Finance Committee Chairman Max Baucus (D-Mont.) reached a deal with the Pharmaceutical Research and Manufacturers of America (PhRMA) vowing not to allow government negotiation if the powerful lobbying group would support the bill. As part of the deal, PhRMA also agreed to put up $80 billion toward the cost of the bill over the next decade — most of that dedicated to closing Part D's coverage gap.  

Conway on Monday also pushed a plan to establish Medicare anti-fraud units in every state.

"I know from having Medicaid fraud units on the ground in each and every state that we're able to stay close and understand what's going on and ferret out fraud," he said. "The problem with Medicare is it's done from a big bureaucracy. I mean, put it in the AG's office or put it in some other office, but just have someone on the ground."

Conservative Republican senator thinks repeal is "highly unlikely" but predicts a "change of heart" for some Democrats.

Why, when faced with a childhood obesity epidemic, would the federal government continue to subsidize corn-based sweeteners suspected of contributing to the problem?

That's the question being posed Tuesday by several leading research physicians at Mount Sinai, who took out an ad in The New York Times asking why Congress subsidizes corn starch but not cauliflower. 

"High-fructose corn syrup [HFCS] now represents 40 percent of the non-calorie-free sweeteners added to U.S. foods. It is virtually the only sweetener used in soft drinks," write Philip Landrigan, Mount Sinai's dean for global health; Lisa Satlin, chair of the pediatrics department; and Paolo Boffetta, deputy director of the school's Tisch Cancer Institute. "Because of the subsidies, the cost of soft drinks containing HFCS has decreased by 24 percent since 1985, while the price of fruits and vegetables has gone up by 39 percent."

It's no coincidence, the doctors claim, that childhood obesity — which has tripled over the past 30 years — is skyrocketing at the same time that HFCS consumption has done the same.

Congress has contributed  — in 2008, lawmakers passed a five-year, $307 billion farm bill that provided billions of dollars in subsidies to farming families earning as much as $2.5 million per year, and often times more. Corn farmers were among the top beneficiaries. 

The law also created a new program to have the government buy surplus sugar for ethanol production. Critics noted that the provision reduces market supply, keeping sugar prices artificially high on the grocery store shelves — and encouraging food and soft-drink manufacturers to use less expensive corn sweeteners.

Although then-President George W. Bush tried to block the farm bill  — arguing that the subsidies shouldn't go to wealthy farmers — lawmakers from both parties stepped in to override his veto.

If Congress ever hopes to get the childhood obesity problem under control, health experts argue, a new look at farm subsidies will be vital. 

"Curbing the obesity epidemic requires a multifaceted approach: education, increased physical activity, healthy school food, promotion of unprocessed foods — and a change in agriculture policy," the doctors write. "Coordinated national leadership is essential." 

Experts would prefer a government authority sets the rates, or an all-payer system.